Skip to main content

Digital Subtraction Angiography in Carotid Artery Stenosis

  • Chapter
Imaging of Carotid Artery Stenosis
  • 1133 Accesses

Abstract

Atherosclerotic disease of the craniocervical vessels is the underlying basis for cerebral thromboembolic stroke in more than 90% of cases in industrialized nations [19]. Craniocervical atherosclerotic vascular disease most commonly and severely affects the internal carotid artery (ICA) origin and the distal basilar artery [19]. The clinical symptoms and morbidity that result from carotid artery disease, the primary cause of stroke, are mainly due to plaque ulceration, thrombosis, intraplaque hemorrhage, and thinned fibrous caps [24]. Clinical benefit of treating symptomatic, severe carotid stenosis has been demonstrated in a number of trials [18], [10]. Therefore the goals of imaging in atherosclerotic craniocervical disease are to determine the degree of carotid stenosis, identify ‘tandem’ lesions in the carotid siphon or intracranial circulation and to evaluate the existing and potential collateral circulation [27]. Conventional catheter angiography remains the standard technique against which other non-invasive modalities (CT, MR) are assessed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 269.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Alexandrov AV, Bladin CF, Maggisano R, Norris JW: Measuring carotid stenosis: time for a reappraisal. Stroke 24: 1292–1296 (1993).

    PubMed  CAS  Google Scholar 

  2. Barnett HJ, Taylor DW, Eliasziw M, Fox AJ, Ferguson GG, Haynes RB, Rankin RN, Clagett GP, Hachinski VC, Sackett DL, Thorpe KE, Meldrum HE, Spence JD: Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators. N Engl J Med 339: 1415–1425 (1998).

    Article  PubMed  CAS  Google Scholar 

  3. Blackshear WM, Phillips DJ, Chikos PM, Harley JD, Thiele BL, Strandness DE: Carotid artery velocity patterns in normal and stenotic vessels. Stroke 11: 67–71 (1980).

    PubMed  CAS  Google Scholar 

  4. Bladin CF, Alexandrova NA, Murphy J, Alexandrov AV, Maggisano R, Norris JW: The clinical value of methods to measure carotid stenosis. Int Angiol 15: 295–299 (1996).

    PubMed  CAS  Google Scholar 

  5. Bousser MG: Benefits from carotid surgery? Yes, but... Cerebrovasc Dis 2: 122–126 (1992).

    Google Scholar 

  6. Chow V, Burbridge B, Friedland R, Kudel B, Chappell B, Tan L: Interobserver variability in the measurement of internal carotid stenosis. Can Assoc Radiol J 50: 37–40 (1999).

    PubMed  CAS  Google Scholar 

  7. Elgersma OE, Buijs PC, Wust AF, van der Graaf Y, Eikelboom BC, Mali WP: Maximum internal carotid arterial stenosis: assessment with rotational angiography versus conventional intraarterial digital subtraction angiography. Radiology 213: 777–783 (1999).

    PubMed  CAS  Google Scholar 

  8. Eliasziw M, Smith RF, Singh N, Holdsworth DW, Fox AJ, Barnett HJ: Further comments on the measurement of carotid stenosis from angiograms. North American Symptomatic Carotid Endarterectomy Trial (NASCET) Group. Stroke 25: 2445–2449 (1994).

    PubMed  CAS  Google Scholar 

  9. Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. JAMA 273: 1421–1428 (1995).

    Article  Google Scholar 

  10. European Carotid Surgery Trialists’ Collaborative Group. Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet 351: 1379–1387 (1998).

    Article  Google Scholar 

  11. Fox AJ: How to measure carotid stenosis. Radiology 186: 316–318 (1993).

    PubMed  CAS  Google Scholar 

  12. Gagne PJ, Matchett J, MacFarland D, Hauer-Jensen M, Barone GW, Eidt JF, Barnes RW: Can the NASCET technique for measuring carotid stenosis be reliably applied outside the trial? J Vasc Surg 24: 449–456 (1996).

    Article  PubMed  CAS  Google Scholar 

  13. Hankey GJ, Warlow CP, Molyneux AJ: Complications of cerebral angiography for patients with mild carotid territory ischaemia being considered for carotid endarterectomy. J Neurol Neurosurg Psychiatry 53: 542–548 (1990).

    Article  PubMed  CAS  Google Scholar 

  14. Hankey GJ, Warlow CP, Sellar RJ: Cerebral angiographic risk in mild cerebrovascular disease. Stroke 21: 209–222 (1990).

    PubMed  CAS  Google Scholar 

  15. Hennerici MG: The unstable plaque. Cerebrovasc Dis; 17Suppl 3: 17–22 (2004).

    Article  PubMed  Google Scholar 

  16. Hyde DE, Fox AJ, Gulka I, Kalapos P, Lee DH, Pelz DM, Holdsworth DW: Internal carotid artery stenosis measurement: comparison of 3D computed rotational angiography and conventional digital subtraction angiography. Stroke 35: 2776–2781 (2004).

    Article  PubMed  Google Scholar 

  17. Lovett JK, Redgrave JN, Rothwell PM: A Critical Appraisal of the Performance, Reporting, and Interpretation of Studies Comparing Carotid Plaque Imaging With Histology. Stroke [Epub ahead of print] (2005).

    Google Scholar 

  18. NASCET Collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with highgrade carotid stenosis. N Engl J Med 325: 445–453 (1991).

    Article  Google Scholar 

  19. Okazaki H: Fundamentals of Neuropathology, 2nd ed., pp. 27–70. Tokyo: Igaku-Shoin (1989).

    Google Scholar 

  20. Rothwell PM, Gibson RJ, Slattery J, Warlow CP: Prognostic value and reproducibility of measurements of carotid stenosis. A comparison of three methods on 1001 angiograms. European Carotid Surgery Trialists’ Collaborative Group. Stroke 25: 2440–2444 (1994).

    PubMed  CAS  Google Scholar 

  21. Staikov IN, Arnold M, Mattle HP, Remonda L, Sturzenegger M, Baumgartner RW, Schroth G: Comparison of the ECST, CC, and NASCET grading methods and ultrasound for assessing carotid stenosis. European Carotid Surgery Trial. North American Symptomatic Carotid Endarterectomy Trial J Neurol 247: 681–686 (2000).

    Article  PubMed  CAS  Google Scholar 

  22. Stapf C, Hofmeister C, Hartmann A, Seyfert S, Koch HC, Mohr JP, Marx P, Mast H: Interrater agreement for high grade carotid artery stenosis measurement and treatment decision. Eur J Med Res 5: 26–31 (2000).

    PubMed  CAS  Google Scholar 

  23. Vaisman U, Wojciechowski M: Carotid artery disease: new criteria for evaluation by sonographic duplex scanning. Radiology 158: 253–255 (1986).

    PubMed  CAS  Google Scholar 

  24. von Ingersleben G, Schmiedl UP, Hatsukami TS, Nelson JA, Subramaniam DS, Ferguson MS, Yuan C: Characterization of atherosclerotic plaques at the carotid bifurcation: correlation of high-resolution MR imaging with histologic analysis-preliminary study. Radiographics 17: 1417–1423 (1997).

    Google Scholar 

  25. Williams MA, Nicolaides AN: Predicting the normal dimensions of the internal and external carotid arteries from the diameter of the common carotid. Eur J Vasc Surg 1: 91–96 (1986).

    Article  Google Scholar 

  26. Willinsky RA, Taylor SM, TerBrugge K, Farb RI, Tomlinson G, Montanera W: Neurologic complications of cerebral angiography: prospective analysis of 2,899 procedures and review of the literature. Radiology 227: 522–528 (2003).

    PubMed  Google Scholar 

  27. Wolpert SM, Caplan LR: Current role of cerebral angiography in the diagnosis of cerebrovascular diseases. Am J Roentgenol 159: 191–197 (1992).

    CAS  Google Scholar 

  28. Young GR, Humphrey PR, Nixon TE, Smith ET: Variability in measurement of extracranial internal carotid artery stenosis as displayed by both digital subtraction and magnetic resonance angiography: an assessment of three caliper techniques and visual impression of stenosis. Stroke 27: 467–473 (1996).

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer-Verlag/Wien

About this chapter

Cite this chapter

Srinivasan, A., Goyal, M. (2007). Digital Subtraction Angiography in Carotid Artery Stenosis. In: Schaller, B.J. (eds) Imaging of Carotid Artery Stenosis. Springer, Vienna. https://doi.org/10.1007/978-3-211-32509-4_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-211-32509-4_5

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-32332-8

  • Online ISBN: 978-3-211-32509-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics